A FAMILY-ORIENTED, HEALTHY EATING, ACTIVITY, AND LIFESTYLE TRAINING WITH HANDS-ON EXPERIENCE (FOR HEALTH) – INTERIM PHASE-1 RESULTS OF A COMMUNITY-BASED PILOT TREATMENT PROGRAM FOR OVERWEIGHT AND OBESE PRESCHOOLERS
Notice bibliographique
Résumé
BACKGROUND: Over 30% of Canadian children and youth, and over 30% of U.S. preschool children are overweight or obese. Overweight 5-year-olds are 4-times more likely to become obese youth. Despite this, evidence to guide management of overweight and obese preschoolers is lacking. OBJECTIVES: To assess the feasibility (Phase 1) and effectiveness (Phase 2) of a 1-year multidisciplinary, community-based intervention for overweight and obese preschoolers to reduce BMI z-score (primary outcome), and to improve health-related quality of life (QoL). Other secondary objectives are to improve dietary choices, physical activity, and to decrease screen time. DESIGN/METHODS: Following physician referral and motivational pre-screening, children 2 to 6 years of age with a BMI ≥ 85th percentile for age and sex are being enrolled to receive intensive multidisciplinary group- and individual counseling, based on Social Cognitive Theory, on strategies to implement healthy dietary and physical activity habits, and on behavioural and parenting aspects. The program, based at a local YMCA, consists of a 4-month intensive phase with ten 90-minute group- and two individual sessions, two subsequent monthly sessions and follow-up at 9 and 12 months. Group sessions consist of parent education, during which children are engaged in guided, active playtime. RESULTS: 12 participants (7 girls; mean age 5.1 years, SD1.03) have so far been enrolled in Phase 1 of the program, 10 completed the intervention (attrition rate 16.7%). Session attendance (86%, SD10.6) and family satisfaction with the program (satisfaction score 55.7 of 60 (93%), SD3.98) have been high. Running the program in the community is feasible, but the referral-based recruitment process has been challenging, with the number of referrals, despite broad advertisement, significantly lagging behind expectations. Interim results are encouraging: for the 10 children who completed the program, mean BMI z-score at 12-months decreased by -0.25 (95%CI -0.08 to -0.42, p=0.013). Screen time decreased by 0.7 hours (95%CI -0.2 to -1.2, p=0.007), Readiness to Change (score 1-5, based on Prochaskas Transtheoretical Model) increased from 4.2 to 4.7 (95%CI 0.12 to 0.92, p=0.025). There was a strong trend towards improved QoL (PedsQL 4.0, scale 0-100) at the end of the core program (6-month mean total score from 65.6 to 76.1% (95%CI -5.0 to +25.9, p=0.08)), but this wasnt maintained during follow-up (12-month score 70.13, 95%CI -10.7 to +19.8,p=0.52). CONCLUSION: The novel 1-year FOR HEALTH intervention is feasible, can be implemented in the community, and has been well received by participating families with low attrition. Interim Phase 1 results show improved BMI z-score, readiness to change and screen time. Recruitment has been challenging.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».